Reflections on Knowledge Translation in Community Health Research in Southern Africa

Olagoke Akintola, MBA, MPH, PhDVisiting Professor, Program in Policy Decision-making, Centre for

Health Economics and Policy Analysis, McMaster UniversitySenior Lecturer Health Promotion Program, University of

KwaZuluNatal, Durban, South Africa

Background

• Focus of research: Intersection of health & development with specific focus on the community level

• Primary health care provides the context• Alma Ata Declaration 1978 Kazakhstan

• Community health care– Work(ers)• Workers• Work

• Community-based organizations

• Interdisciplinary work drawing on:– Social and organizational psychology– Health psychology– Positive psychology– Public health– Community development– Feminist economics– Gender and health– Political economy

• Caregivers and care work– Workers’ gender & gendered nature of care

(Akintola 2004ab;2006)

– Workers’ health: stress, burnout=burden of care(Akintola 2008; Akintola, Hlengwa, Dageid

2013)– Work environment/conditions: motivations,

rewards/remuneration, employment opportunities, career advancement, job creation

• Caregivers and care work– ‘Meaning of working’ among paid AIDS care

employees (Akintola & Ntetha forthcoming)• Meanings attached to working influences

– Job performance– Satisfaction– Absenteeism– Turnover/Attrition

• Community-based organizations– Paid care workers in CBOs (Akintola & Chikoko

forthcoming)– Access to funding– Impact of the global financial crisis

• Political economy of care/care economy• AIDS care economy/political economy of AIDS

care (Akintola, 2006; 2008)– Value of time spent by caregivers– Cost of hospital care versus community/home care

• Access to resources in home care– Training resources (Akintola & Dlamini

forthcoming)– Psychosocial support (Akintola & Gwelo

forthcoming)– Social support (Akintola & forthcoming)

• Social capital and care– The role of social capital in accessing resources for

HBC (Akintola 2011; Dageid et al, 2011)– Community-based organizations and their roles in

health and development (Dageid et al, 2011)– Community participation in health and

development (Dageid et al, 2011)

• Care and poverty– Exploring the links between AIDS care and poverty• Opportunity costs: impact on agriculture or paid work• Financial costs• Material costs

Research to Policy: Strategies and Experiences

• Presentation at International conferences– Bangkok AIDS conference 2004=• conference media coverage• Internet• Hosted on several health, development and gender

websites• Interviews 1) IRIN (UN internet newspaper 2)national

South African radio service• E-mail request for policy paper from researchers, NGOs

and advocacy agencies working on development, gender & health

• Use of other packaged research evidence. (KT Products): Policy Briefs; Policy Papers (HEARD Website 2004)

• Focus on Gendered burden of care– Request for further research from International

NGO: ActionAID International– Publication for ActionAID used mainly for advocacy– Launched at Africa AIDS conference, Abuja 2005– Other advocacy/lobbying activities

• Invitations to present at International forums of academics, policy advocates, international organizations & to contribute to UN policy documents.– Outcomes• Development of policy documents for UN Sec Gen

report to the Commission of Status of Women • Policy meetings/documents on extreme poverty and

care at the UN Geneva

• Invitation to partner with International advocacy NGOs (Huairou Commission, New York)– Outcome: • multi-country research on remuneration of volunteer

caregivers• Used for advocacy & lobbying at the UN Commission on

the Status of Women & other fora

Social capital project

• Use of further research for dissemination and participation

• Community dissemination of research findings• Community participation in knowledge

translation –skits, recording• Stakeholder participation in dissemination of KT

products (DVD), participatory community drama

•

• Comics/cartoons distributed throughout study community

• Skits dissemination through the internet

• Academic publications in peer-reviewed journals

• Edited scholarly book on social capital and AIDS for academics, students, teaching, researchers, policymakers

Concluding thoughts

• KT product developed based on intended audience• Research to policy could be a slow process• Dissemination does not necessarily imply uptake• But necessary step towards uptake• In our studies we sought to create awareness among policy

makers at the global level • There is anecdotal evidence that findings percolate and

eventually get to policymakers• Partnerships with other organizations• Studies generates snowball effect among researchers and

advocates and lobbyists